Report of the Director of Public Health

This report gives an overview of some of the current population health inequalities in Manchester and provides examples of how partners across our population health and wellbeing system work collaboratively to address them. The examples include a particular focus on social prescribing as requested by the committee. The report also covers the work of COVID-19 Health Equity Manchester (CHEM) and the important lessons learned for ongoing work to promote health equity in the City. Finally, it summarises the next steps for Population Health Recovery within the context of the pandemic, and how Manchester would be responding to “Building Back Fairer in Greater Manchester” - the post-pandemic recommendations made for Greater Manchester as a Marmot City region.

The Committee considered the report of the Director of Public Health that gave an overview of some of the current population health inequalities in Manchester and provided examples of how partners across our population health and wellbeing system worked collaboratively to address them. The examples included a particular focus on social prescribing as requested by the Committee. The report also covered the work of COVID-19 Health Equity Manchester (CHEM) and the important lessons learned for ongoing work to promote health equity in the City. Finally, it summarised the next steps for Population Health Recovery within the context of the pandemic, and how Manchester would be responding to “Building Back Fairer in Greater Manchester” - the post-pandemic recommendations made for Greater Manchester as a Marmot City region.

Key points and themes in the report included:

·         An overview of the Manchester’s Population Health Plan (2018-2027), the city’s overarching plan for reducing health inequalities and improving health outcomes for Manchester residents;

·         What health inequalities looked like for Manchester’s population;

·         Population Health Recovery Framework;

·         Health equity and the impact of the COVID-19 Pandemic;

·         Delivering the Population Health Plan – Examples of collaborative working;

·         Whole system approach to population health and wellbeing;

·         Taking action on preventable early deaths;

·         COVID-19 Health Equity Manchester and its objectives and activities;

·         Manchester Health and Care Commissioning (MHCC) – addressing health inequalities in health and care; and

·         Next steps, including the Marmot Task Group and refresh of Manchester’s Population Health Plan and delivery of Manchester’s Population Health Recovery framework and associated flagship programmes.

The Committee heard from Valérie Touchet, citizen of Manchester, who spoke of her experience of engaging with her Employment Coach at One Manchester. She spoke of her circumstances that led to her engagement with this service and the positive outcomes that she had experienced. The Committee expressed their appreciation to Ms Touchet for attending and speaking to the Committee. Members expressed the importance of continuing to appropriately engage with people to keep enquiring if they were okay and to be there when assistance was required.

The Chief Medical Officer, MLCO, stated that all partners across the MLCO embraced the Our Manchester approach and were committed to delivering better outcomes for residents, noting that that the question that was asked by practitioners was ‘what matters to you?’ rather than ‘what is the matter with you?’ which was indicative of the approach taken.

The Committee then heard from Hendrix Lancaster, Coffee4Craig who described a case study that he had circulated to Members of the Committee in advance of the meeting. In response to this example the Executive Director of Adult Social Services stated that she remained committed to reviewing the services provided for homeless people, adding that a Health and Homelessness Group had been established that included key partners and stakeholders. She said that a report to the Committee on this work could be provided at an appropriate time. In reply to the issue raised in the case study regarding the lack of identification, the Director of Public Health stated this issue would be looked at. The Executive Clinical Director MHCC stated that ID was not required to access Primary Care and she suggested that the issue of unconscious bias was evident in the case study and she would take that away from the meeting for further discussion. Members commented on the importance of tackling unconscious bias so that people were not denied the appropriate care and access to services.

The Chair commented that examples of relatively small scale interventions, such as the installation of age friendly benches at key locations, should be rolled out across the city and more work needed to be done with business to implement schemes, such as the slow tills in supermarkets. The Director of Public Health commented that positive relationships had been strengthened with businesses during the response to the pandemic and the intention was to build upon these relationships to deliver equivalent schemes and initiatives. He further commented that Age Friendly Manchester were a partner of the MLCO.

In response to a question regarding the impact on residents, particularly older residents who were having to wait longer for routine surgery that resulted in people having to endure painful conditions, the Consultant in Public Health Medicine described that the ‘While You Wait’ programme had been commissioned to support those residents in this situation.  

The Committee then heard from Atiha Chaudry, Associate Lead for Manchester BME Network, who described the positive and important work of the South Asian Sounding Board. She described that their work had been invaluable during the pandemic to engage with and inform residents around the issue of COVID-19 and the vaccination. She described that this engagement and sharing of information was vital to build confidence amongst residents, challenge misconceptions using trusted community champions in an appropriate manner to address health inequalities. She stated this model could be replicated to target engagement activities with other communities and groups across the city.

The Consultant in Public Health Medicine discussed the vaccination programme in relation to both the local African community and the Caribbean community, noting that it was important to recognise the two distinct groups and their unique experience and history in Manchester. She described the important role of the relevant Sounding Boards and engagement of community leaders which were vital to understanding their experience and relationship with health services in Manchester. She further stated that the design and delivery of the COVID chats had proven to be very positive.

The Director of Workforce, OD and Inclusion stated that it was important to address the structural inequalities in systems and services to promote and deliver inclusive services. She described that this approach and understanding was central to the work of COVID-19 Health Equity Manchester (CHEM). CHEM had been set up in July 2020 in response to the disproportionate impact that was increasingly evident in some of Manchester’s communities. The group aims were to achieve its objectives through collaborative whole system working, influence and advocacy as well as direct actions through its programme of work.

In response to a specific question relating to smoking cessation and pregnancy, the Director of Public Health stated that he would seek to obtain the data requested regarding rates of smoking post child birth.

In concluding this item of business, the Chair thanked all representatives in attendance for contributing the Committees deliberations. She said that the Committee welcomed their continued work and commitment to addressing the health inequalities across the city.

Decision

The Committee;

1. Note the report and express their appreciation to all those engaged in the delivery of this important area of work; and

2. Recommend that the Director of Public Health consult with members of the Committee when establishing the Marmot Beacon Indicators that are within the remit of the Committee.